注意缺陷多动障碍儿童睡眠结构变化  

The sleep structure of children with attention deficit hyperactivity disorder

作　　者：吕凌云[1] 张建昭[1] 刘肖予 王芳[1] 李冬青[1] 王立文[1] 杨健[1] 

机构地区：[1]首都儿科研究所附属儿童医院神经内科,北京100020

出　　处：《中华实用儿科临床杂志》2015年第24期1877-1879,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 探讨注意缺陷多动障碍（ADHD）儿童的睡眠结构,比较ADHD各亚型之间睡眠结构的差异.方法 选择2012年6月至2013年6月首都儿科研究所附属儿童医院神经内科门诊确诊的ADHD儿童90例（ADHD组）,男75例,女15例;年龄6-14岁[（9.5±2.4）岁].其中混合型55例,注意缺陷型25例,多动/冲动型10例.健康对照组（30例）来源于北京及周边地区,且年龄、性别与ADHD组相匹配的健康儿童,男23例,女7例;年龄6-14岁[（9.2±2.9）岁].对ADHD患儿及健康儿童进行全夜睡眠结构分析.结果 ADHD组儿童快速动眼期（REM）潜伏期为（146.58±47.28） min、睡眠潜伏期为19.00 min[（8.25 -37.50）min];健康对照组REM潜伏期为（87.55 ±13.59） min、睡眠潜伏期为9.00 min[（3.50- 13.63） min].ADHD组儿童REM潜伏期及睡眠潜伏期比健康对照组长,睡眠效率及总睡眠时间比健康对照组差,觉醒次数较健康对照组明显增多、总觉醒时间比健康对照组长,差异均有统计学意义（P均＜0.05）.ADHD混合型的非快速动眼期（NREM）Ⅱ期百分比较ADHD注意缺陷型低（t=2.012,P ＜0.05）;ADHD注意缺陷型的睡眠潜伏期较ADHD混合型长（t=2.964,P ＜0.05）;其他各型间各指标差异均无统计学意义.ADHD组有25例出现睡眠周期性肢体运动（PLMS）,发生率为27.78％（25/90例）;健康对照组仅1例出现PLMS,发生率为3.30％（1/30例）,2组PLMS发生率比较差异有统计学意义（x2=8.053,P＜0.05）.结论 ADHD儿童存在睡眠结构的改变,ADHD注意缺陷型和ADHD混合型存在睡眠潜伏期及NREMⅡ期的差异.Objective To investigate the sleep structure of children with attention deficit hyperactivity disorder （ADHD） and the differences among subtypes of ADHD.Methods Ninety children with ADHD were diagnosed in Department of Neurology, the Children＆#39;s Hospital Affiliated to Capital Institute of Pediatrics between June 2012 and June 2013, including 75 boys and 15 girls,6-14 years old [（9.5 ± 2.4） years old], and among them there were 55 cases of ADHD-combined type, 25 cases of ADHD-inattentive type, and 10 cases of ADHD-hyperactive impulsive type.Thirty healthy children whose age and sex matched with ADHD group,came from Beijing and the surrounding area,were selected as the healthy control group,including 23 boys and 7 girls,6-14 years old [（9.2 ± 2.9） years old].Two groups underwent full overnight sleep assessment.Results The latency of rapid eye movement（REM） in children with ADHD was （146.58 ± 47.28） minutes, and the sleep latency was 19.00 minutes [（8.25-37.50） minutes];while the latency of REM in healthy control group was （87.55-± 13.59） minutes, and the sleep latency was 9.00 minutes [（3.50-13.63）minutes].Compared with healthy control group, children with ADHD demonstrated the increased latency REM and sleep latency, and decreased sleep efficiency,the increasing times of awakening and total duration,and these differences were all statistically significant（all P 〈 0.05）.The percentage of non-rapid eye movement（NREM） phase Ⅱ in ADHD hybrid was lower than the ADHD attention-deficit（t =2.012,P 〈 0.05）.Sleep latency in ADHD attention-deficit was longer than the ADHD hybrid（t =2.964,P 〈 0.05）.No statistical differences were found among the various types in other indicators.The prevalence of periodic limb movements in sleep（PLMS） was 27.78% （25/90 cases） in ADHD group and the prevalence of PLMS was 3.30% （1/30 cases） in the healthy control group.The differences in prevalence between 2 groups were statistically significant （x2 =8.053, P 〈 0.0

关 键 词：注意缺陷多动障碍 睡眠结构 儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学]